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Head of Mission, Logistics Coordinator,. Administration Coordinator, Technical Referent,. Technical .... Hermel. Hermel.
Handicap International - Lebanon Multisectorial Assessment Report

HANDICAP INTERNATIONAL Multisectorial Assessment Report Bekaa Valley, Lebanon August 2012 Sylvain RICCIO – Emergency Roving Manager

Handicap International - Lebanon Multisectorial Assessment Report

INTRODUCTION BACKGROUND General context: The unrest in Syria began in the southern city of Deraa in March 2011 and the military crackdown failed to stop it, instead triggering anti-government protests in other towns and cities across the country, including Baniyas, Homs, Hama, Idled, Aleppo and the suburbs of Damascus. The Syrian authorities have responded to anti-government protests with overwhelming military force since they erupted. Since the beginning of the crisis, 26,000 people were killed according the last toll of the Syrian Observatory for Human Rights. In addition, 1.2 million of people are relocated due to the unrest. It has also caused the displacement of civilians fleeing from violence in the neighbouring countries, mainly in Lebanon, Jordan and Turkey. According UNHCR, the total number of Syrian refugees registered in these countries stands at 192, 427 persons, with 18, 1 682 in Iraq, 48, 014 in Jordan, 45, 3012 in Lebanon and 80, 410 in Turkey . Lebanon: Over 57,000 displaced Syrians are receiving protection and assistance in Lebanon through the efforts of the Government of Lebanon and UN and NGO partners. Of this number, 42,947 are registered, with an additional 2 14,952 people having been in contact with UNHCR to be registered . A total of 17,827 Syrians (3,846 families) have been registered with UNHCR in the Bekaa. Half of the populations of refugees are minors and most of them are accommodated by host families or rent some accommodation. However, an increasing tension is to be noted between Syrian refugees and host communities as prices are rising and humanitarian assistance is targeting refugees only. Bekaa and Akkar are historically the country’s poorest districts, and targeted support has been reported for the last 3 months by community leaders as socially destructuring. Finally, the coming winter will contribute to deteriorate their conditions of life, improving therefore the vulnerabilities of the families. Handicap International [HI] has started its emergency response in Northern Bekaa Valley in March 2012, providing support for most vulnerable households – with a special attention to persons with disabilities, injuries or chronic diseases – through the “Disability & Vulnerability Focal Point” [DVFP] approach. In summer 2012, the conflict-affected population influx has drastically increased in Bekaa Valley and HI decided to launch a comprehensive multisectorial assessment in order to adapt its intervention to the dynamic humanitarian context. OBJECTIVES General objective: Improve HI knowledge of the humanitarian situation in Lebanon to feed HI positioning for coming months. Specifics objectives: • Assess current and upcoming needs in Bekaa Valley; • Assess humanitarian capacities to answer current and upcoming needs in Bekaa Valley; • Provide technical and operational recommendations to answer the identified needs; • Provide recommendation for HI positioning in basic needs coverage, taking into consideration both humanitarian situation and HI capacities. Assessments have been carried out by other agencies, such as: • DRC Livelihood assessment (May 2012); • ACF WASH assessment (June 2012); • UNDP/DMI assessment (August 2012); 1 2

http://data.unhcr.org/syrianrefugees, September 5th 2012 UN Inter-Agency Response, Monthly overview, August 2012

Handicap International - Lebanon Multisectorial Assessment Report

• MSF study (August 2012). HI assessment took into consideration all the inputs and therefore tried not to redo an existing work.

TARGET AREA The assessment focused on 4 Cazas in Bekaa Valley, Lebanon: Hermel and Baalbeck (North Bekaa), Zahle (Central Bekaa) and West Bekaa (West Bekaa).

TARGET POPULATION Conflict-affected population (Syrian refugees, Lebanese returnees and minorities such as Palestinian refugees) and host communities.

Handicap International - Lebanon Multisectorial Assessment Report

I. METHOD I.1. OVERVIEW The main steps of the forecasted assessment – detailed hereafter – are the following: N°

Description

Collaborators

Outputs

1

Internal Coordination at Headquarter level

Desk Officer, Deputy Desk Officer, Logistics Referent.

Briefings and document sharing

2

Internal coordination at field level

Head of Mission, Logistics Coordinator, Administration Coordinator, Technical Referent, Technical Advisor, DVFP Program Manager.

Briefings and document sharing

Local authorities: municipality, High Relief Committee, Community Leaders. 3

External Coordination

Humanitarian coordination: UN agencies, I/L NGOs, Red Cross / Red Crescent Movement. Local Charities.

4

Needs assessment featuring: field observations, informal group discussions and household surveys.

HI Field Team: Head of Assessment, Assessment Assistant, Team of 4 Assessors. Target population: Refugees and Host communities.

4W Mapping (Who/What/Where/When) Minutes of meetings Meeting database Field observation reports Informal discussion group reports Assessment forms Statistical analysis

I.2. QUALITY TOOLS I.2.1. The URD Quality Compas As from the URD website: “The Quality COMPAS is the result of a six-year research project on quality issues in the humanitarian sector. The Quality COMPAS is a Quality Assurance method which comes equipped with its own set of tools, training modules and consultancy services. These components have been designed specifically 3 for aid agencies with the overall aim of improving services provided to crisis-affected populations.” HI currently uses the URD Quality COMPAS during project implementation. During this assessment, HI team used it to keep in mind the key criteria and processes of a quality project when recommendations and concept notes have been drawn.

I.3. LIMITATIONS

3



The political nature of the Syrian crisis restrained some participants from responding to sensitive questions, such as whether Syrian refugees constitute a burden on Lebanese hosting families;



Difficulties to select a random sample: most of the time, no beneficiaries list exist and conflict-affected populations keep changing location. Therefore, real margin of error is higher than calculated one;



Necessity to coordinate with local authorities before launching field activities;



Some local authorities requested time to process HI request and therefore could not be covered by the assessment.

http://www.compasqualite.org/en/index/index.php

Handicap International - Lebanon Multisectorial Assessment Report

II. COORDINATION

II.1. EXTERNAL COORDINATION Objective: to understand the current management of the crisis by local authorities and humanitarian agencies. Collected data helped the Assessment Team to draw a clear picture of assistance capacities and compare them with existing and/or residual needs. Sum-up of meeting held by the assessment team:

LNGOs / Charities

Humanitarian agencies

Local authorities

Type

Title

Organization

Date

Introduction meeting

Jdeideh Municipality

17/08

Introduction meeting

Hermel Municipality

18/08

Introduction meeting

Britel Rural Development

21/08

Introduction meeting

El Ain Municipality

24/08

Introduction meeting

Aarsal Municipality

25/08

Introduction meeting

Douris Municipality

27/08

Introduction meeting

Baalbeck Municipality

27/08

Introduction meeting

Majdel Anjar Municipality

30/08

Introduction meeting

Saadnayel Municipality

31/08

Introduction meeting

Terbol Municipality

01/09

Introduction meeting

Bar Elias Municipality

01/09

NFI Cluster Meeting

Humanitarian agencies

22/08

WASH/Shelter Cluster Meeting

Humanitarian agencies

22/08

Information sharing

DRC and SIF

22/08

Information sharing

ACF Spain

28/08

NFI Cluster Meeting

Humanitarian agencies

05/09

WASH/Shelter Cluster Meeting

Humanitarian agencies

05/09

Information sharing

Al Irshad Wal Islam

27/08

Information sharing

Al Rifai

28/08

Information sharing

Dar EL Fatwah

29/08

Information sharing

Al Weis organization for Dvt

01/09

Information sharing

Jdeideh convent responsible

21/08

11 meetings with Local Authorities, 6 meetings with humanitarian agencies and 5 meetings with LNGOs / Charities leading to a total of 21 meetings.

Handicap International - Lebanon Multisectorial Assessment Report

III. FIELD SURVEY Objective: get a global picture of the access to basic services, cross-check collected data at coordination level, get a feeling of refugees & host communities’ current situation and try to collect opinion from various groups. The field visits were led by technical staff, experienced in assessing quantity & quality of local infrastructures 4 providing basic needs to both Syrian refugees and Lebanese host communities. Observations were made taking into consideration the Bekaa Valley climate, especially during the upcoming winter.

IV. INFORMAL GROUP DISCUSSIONS Given the following considerations: •

Other agencies comprehensive assessment providing reliable, consistent and clear outputs;



Complexity of field constraints (lack of access to beneficiaries, mandatory strong coordination with local authorities…);



Decrease of assessment acceptance from both conflict-affected population and local authorities;

The Head of Assessment decided not to include formal Focus Discussion Groups. However, informal group discussions were carried out on an ad hoc basis.

V. HH SURVEYS A specific form was designed in collaboration with HI headquarters, DVFP PM and assessment staff. It was used by assessors to facilitate interviews, data collection and integration in an EXCEL™ database.

V.1. SAMPLE CALCULATION th

The chart below shows the registered refugees in Bekaa valley (July 27 2012): Note: number of households are estimated using the average ratio of 4.5 persons / household (UNHCR). Refugees population Caza

% of total Persons

Households

Bekaa

6.226

1.384

52,4%

Hermel

361

80

3,0%

West Bekaa

1592

354

13,4%

Zarleh

3711

825

31,2%

TOTAL

11.890

2.643

100,0%

In order to calculate the sample size, HI considered the household being the measured unit. As shown in the th chart, the number of registered households is 2.643 (July 27 2012). However, as the figures increased when assessment started, HI based further sample calculation on a basis of 3.000 households. (Note: at the time of reporting, number of registered households is over 3,800). Below 100.000 targeted units, the following formula is used:

4

e.g. accommodation, schools, water networks, toilets, drainage systems, public buildings…

Handicap International - Lebanon Multisectorial Assessment Report

Where n = sample size, N = target population (3,000 households). Calculation leads to n = 341 In order to break the total target by towns, HI based its estimation on UNHCR’s population data. Only the main cities hosting conflict-affected populations have been considered. However, some constrains appeared during the work: • According to municipalities and UNHCR, there are no refugees in Terbol and Joub Jannine; • Taalabaya Municipality requested too much time to process HI request. As a consequence, the sample breakdown was changed. The following chart gives the initial and the final plans:

Initial estimation District

Village

Final Sampling

HH %

Sample

%

Sample

Baalbeck

Aarsal

500

21.9%

67

23.2%

73

Baalbeck

Baalbeck

388

17.0%

54

17.1%

54

Baalbeck

Britel

20

0.9%

3

1.0%

3

Baalbeck

Douris

43

1.9%

6

1.9%

6

Baalbeck

El Ain

88

3.9%

13

4.2%

13

Baalbeck

Fakehe

77

3.4%

11

3.5%

11

Baalbeck

Laboue

16

0.7%

2

0.3%

1

Baalbeck

Qaa Baalbeck

154

6.8%

21

6.7%

21

Hermel

Hermel

82

3.6%

13

3.2%

10

West Bekaa

El Marj

63

2.8%

14

4.4%

14

West Bekaa

Ghazze

66

2.9%

14

4.4%

14

West Bekaa

Joub Jannine

78

3.4%

15

0%

0

Zahle

Bar Elias

149

6.5%

22

11.1%

35

Zahle

Dalhamyie

38

1.7%

7

3.5%

11

Zahle

Majdel Anjar

69

3.0%

11

6%

19

Zahle

Qabb Elias

103

4.5%

15

0%

0

Zahle

Saadnayel

204

9.0%

30

9.5%

30

Zahle

Taalabaya

44

1.9%

8

0%

0

Zahle

Terbol

96

4.2%

15

0%

0

TOTAL

2278

100.0%

341

100.0%

315

As the sample size slightly changed, it is necessary to estimate the associated margin of error from:

Where e = margin of error. z = a constant from the Normal Law (1.96 is commonly used). p = repartition (0.5 is commonly used). Calculation leads to e = 7.8%. Note: as sampling cannot be 100% random due to field constraint, real margin of error is over calculated one.

Handicap International - Lebanon Multisectorial Assessment Report

V.2. RESULTS V.2.1. Household data Status of Household

Age repartition of households’ members (total of 2,203 people)

4,4% 41,3% 17,2%

20,2% 15% 16,9%

Number of people per household: Minimum = 1

Maximum = 27

Average = 7

Standard deviation = 3,4

Household members’ vulnerability:

Protection:

36 persons with injuries (16‰);

22 tortured persons (10‰);

35 persons with disabilities (16‰);

11 GBV survivors (5‰);

60 pregnant and/or breastfeeding women (27‰);

Handicap International - Lebanon Multisectorial Assessment Report

85%

Presence of the head of household:

15%

80% of the time, the Head of household was present for the interview

Status of Head of Household: 18 interviewed head of households (5.7%) presented 2 of the listed criteria. Mostly are elder widows or elderly suffering from chronic disease

Age of Head of Household Minimum = 18 years old

80 – 90 years old 60 –80 years old 50 – 60 years old 40 – 50 years old 30 – 40 years old 20 – 30 years old 10 – 20 years old 10 – 20 years old

Family links:

Socio-economy:

Maximum = 84 years old

Average = 42 years old

Standard deviation = 12

Handicap International - Lebanon Multisectorial Assessment Report

V.2.2. Socio-economical data

Rent

Furniture

Electricity

Communication

Transport

Employment

A – Very Poor

B - Poor

C - Struggling

D – Better Off

Too expensive

Expensive

Affordable

Easily affordable

(high debt)

(medium debt)

(small debt)

(no debt)

8,1%

26,6%

16,0%

49,3%

None

Little or in bas conditions

Some basic furniture

Enough

19,7%

47,0%

27,0%

6,3%

None / not affordable

Less than half the time

Most of the time

Always (network + generator)

2,2%

51,4%

14,0%

32,4%

Nothing

1 mobile phone, no credit

1 mobile phone with credit

> 1 mobile phone with credit

20,3%

52,4%

15,5%

11,7%

Nothing

Bicycle

Bike or car in bad conditions

Bike or car in good conditions

76,2%

0,6%

19,0%

4,1%

Nobody is working

> 1 person is working

54,3%

45,7%

Income Low / irregular

Medium / most regular

High and regular

None

52,6%

39,7%

7,0%

0,7%

Total socio-economy:

Very Poor

Poor

Struggling

Better Off

35,1%

42,5%

14,1%

8,3%

Handicap International - Lebanon Multisectorial Assessment Report

V.2.3. Habitat Type of habitat

Unfinished flats / houses are concrete buildings with a finished structure (columns, beams and roof) and concrete brick walls. Floor is not always finished and there are no doors or windows. A temporary electricity supply is set up and water is supplied by water trucking or neighboring taps. Tents are installed most of the time in private lands or fields. They are made of a wood or metallic structure covered with rages, plastic sheet or cardboard. Garages are closed by a metallic door and usually are located directly on a street. Rental fees

Facilities 78.7% have access to a proper kitchen. 19.7% share their kitchen with other families. 83.2% have access to proper bathroom (not taking into consideration water heating system). 27.9% share their bathroom with other families. 14.0% have access to a living room. This tends to show that houses are crowded and do no ensure individual privacy. 4.8% share their living room with other families. People per sleeping room Minimum = 1

Maximum = 16

Average = 5

Standard deviation = 2

Available surface per person This data has to be compared to the minimal SPHERE standard (3.5 m² / person). Minimum = 2 m²/person

Maximum = 63 m²/person

Average = 1 m²/person

Standard deviation = 9

Winter preparedness 61.3% of the houses are not prepared to face winter (lack of windows or doors and any isolation gap). 45% of households do not have any heating system. Given the harsh winter season in Bekaa Valley, it is a real threat to living conditions, especially for persons at risk (children, pregnant women, persons suffering from chronic diseases…)

Handicap International - Lebanon Multisectorial Assessment Report

Habitat VS social insertion

The habitat is considered to facilitate social insertion when: •

There are no major difference between the conflict-affected household’s habitat and the locals’ habitat. For example, tents do not facilitate social insertion;



The conflict-affected family can receive guests for socialization (enough space, basic furniture…);

Habitat VS intimacy / dignity

43.5% 56.5%

The habitat is considered to ensure intimacy/dignity when: •

Parents have their own room, separated from children;



Minimum space is available for private activities.*

Habitat VS protection Can the habitat easily be spotted as hosting refugee from outside?

40.3% 43.5% 0.6% 37.0% of the assessed buildings can be easily entered. Among the unprotected habitats, 81.7% can be easily entered due to lack of functional door and 18.3% due to non resistant walls.

Handicap International - Lebanon Multisectorial Assessment Report

V.2.4. WASH Source of drinking water

Taps and public water points car be linked to water supply networks, boreholes or tanks willed by water trucks. ACF WASH assessment outputs propose more disaggregated data:

Distance from house to water source (when outside the dwelling):

77.7% of the interviewee thinks the water they use is actually drinkable. However, this perception has to be compared to ACF’s water quality testing campaign. Household water treatment The majority of households drink tap water without any treatment. According to ACF report, « among the 44 % of the population who has mentioned health problems, 20 % of the population said they have suffered diarrhea during the mentioned period »

Handicap International - Lebanon Multisectorial Assessment Report

Source of water for cleaning & hygiene

Quantity of available water 51.7% of interviewed households state they have enough water to cover their daily needs. Cost of water 50.8% of interviewed households do not pay for water. Cost of water trucking depends on distance covered by the service provider. A fair estimation is 1 $ / 100 L. Access to toilets 86.7% of interviewed households have access to toilets. Among the available toilets, 74.0% are clean and functional, 72.2% secured and 7.7% have their septic tank full. 88.6% of toilets are shared by than 20 persons / unit (i.e. above SPHERE Standards). Almost all latrines are located less than 50m from the household habitat. Availability of Non Food Items Criteria: Jerrycan: > 1 unit / household;

Towel: 1 unit / adult – 1 unit for children;

Soap: 250 g / person / month (SPHERE standards);

Nail cutter: > 1 / household

Tooth paste: > 1 unit of 75 mL / 5 persons / month;

Baby potty: > 1 unit / household

Tooth brush: > 1 unit / person / 3 month; Green: > 66% of households have access to the item; Orange: 33 – 66% of households have access to the item; Red: < 33% of households have access to the item. AVAILABLE HYGIENE ITEMS Jerrycan

Bathing soap

Tooth paste

Toothbrush

Hairbrush

Towel

Nail cutter

Laundry soap

Baby potty

Personal hygiene

67.0%

83.8%

81.9%

80.6%

76.2%

61.9%

61.3%

70.2%

10.8%

48.9%

AVAILABLE OTHER NFI Matress

Bedsheets

Kitchen set

Clothes

Blankets

Shoes

Other lacking?

Winter clothes?

70.8%

39.0%

65.1%

39.4%

40.0%

39.0%

38.1%

1.6%

Handicap International - Lebanon Multisectorial Assessment Report

Psychosocial Green: < 33% of households present the symptom; Orange: 33 – 66% of households present the symptom; Red: > 66% of households present the symptom.

Sleeping trouble

Feeling of Loneliness

Eating trouble

Sadness

Feeling of persecution

Fear of family separation

52.1%

41.3%

40.3%

92.1%

26.3%

42.5%

Uncontrolled crying

Uncontrolled aggressiveness

Concentration trouble

Flashes about the past

Shame / Guilt

43.2%

22.9%

22.5%

46.3%

26.3%

Does the household feel included in the society?

If the household does feel included, through which activities? 15.9% through sports

22.0% include through schools

17.8% include through games

55.1% include through religion

22.6% include through ceremonies

12.7% include through informal gathering

25.8% include through work If the household does not feel included, why?

Access to Primary Health Center

Handicap International - Lebanon Multisectorial Assessment Report

Access to Hospital

Access to Pharmacy

Specific needs In addition, 123 households (842 persons) were assessed using a complementary form focusing on specific needs in Central and West Bekaa, where HI does not intervene yet. Specific needs due to the conflict 1 adult was injured and has now difficulty to move. Needs of mobility devices and rehabilitation care have been reported. 1 child with severe nervous disorders probably linked to trauma. Specific needs not due to the conflict 2 adults showed significant difficulties to move. Needs of orthotics and rehabilitation care have been reported. 1 adult and 1 teenager with trisomia 21.

Handicap International - Lebanon Multisectorial Assessment Report

LIST OF ACRONYMS

4W

Who / What / Where / When

ACF

Action Contre la Faim

DMI

Development Management International

DRC

Danish Refugee Council

DVFP

Disability & Vulnerability Focal Point

GBV

Gender Based Violence

HI

Handicap International

MoM

Minutes of Meeting

MSF

Médecins sans Frontières

NFI

Non Food Items

NGO

Non Governmental Organization

NRC

Norwegian Refugee Council

PM

Program Manager

UN

United Nations

UNDP

United Nations Development Program

UNHCR

United Nations High Commission for Refugees

URD

Urgence Reconstruction Développement

WASH

Water, Santiation and Hygiene

Contacts

Head of Mission + 961 76 32 46 40 [email protected] www.handicap-international.org

Disability and Vulnerability Focal Point project manager - Bekaa + 961 78 81 53 93 [email protected]

HI Bekaa hotline service 71 804 820